Circulating Endothelial Progenitor Cells: Potential Biomarkers for Idiopathic Dilated Cardiomyopathy

Dilated cardiomyopathy (DCM) remains the most frequent cause of cardiac transplant and thus results in an enormous cost burden for health care systems worldwide. Although DCM is thought to be induced mainly by genetic and/or environmental factors, the cause is unknown in the majority of cases, giving rise to the term idiopathic DCM. Marked cardiac endothelial changes are associated with disease progression and outcome, and there are ongoing efforts to identify biomarkers that have diagnostic and prognostic value. Here, we discuss the potential and the limitations of circulating endothelial progenitor cells (EPCs) as minimally invasive serological biomarkers for DCM. In this context, it is essential to further evaluate their clinical utility independently of other variable factors that can also affect EPC levels such as age, gender, lifestyles, and treatments. To that end, large multicenter studies and standardized instrument settings, reagents, and sample preparation protocols are needed to confirm this.